Three-dimensional analysis of dentolabial relationships: effect of age and sex in healthy dentition

Morphological changes in three-dimensional (3D) dentolabial relationships during ageing were assessed in healthy individuals. 38 subjects with healthy dentition were analysed. They were divided into a youthful group (21–34 years, mean 26 years, SD 4) and an older group (45–65 years, mean 53 years, SD 5). Stone labial and dental models were made, digitized and 3D virtual reproductions of dentolabial morphology were obtained. From the digital reconstructions, the relative positions of the labial commissure and of the maxillary dental clinical crowns in the vertical direction were obtained. Sex and age effects were compared using two-way analysis of variance. Lip position relative to the teeth was significantly different in youthful and older subjects (P < 0.01). No statistically significant effects of sex in dentolabial relationship were demonstrated, but a sex × age effect was found in the anterior labial segments (P < 0.05). The perioral soft tissues drop down in older subjects and the soft tissue descends on the entire labial arch. These differences may help the clinician when estimating, planning and evaluating surgical, orthodontic and prosthetic treatments.     

Usefulness of the Aesthetic Result as a Success Criterion for Implant Therapy: A Review

Purpose: The purpose of this study was to review the reported evaluation criteria of the aesthetic result in oral implant rehabilitation. Materials and Methods: A literature search of MEDLINE, the Cochrane Collaboration, and EMBASE was performed to retrieve studies published between January 1990 and December 2008 using the following key words: “dental implants,”“clinical trial,” and “aesthetic index” (and their synonyms). A manual search of the literature published in the same period was also carried out using the following publications: Clinical Oral Implant Research, The International Journal of Oral and Maxillofacial Implants, and The International Journal of Periodontics and Restorative Dentistry. The inclusion criteria of the published studies were the following: human clinical trial, oral implant rehabilitation, at least 10 implants, at least 6 months of follow‐up from insertion of the prosthesis, and evaluation of the aesthetic result by means of an index. Results: The literature search revealed 650 relevant bibliographic references, of which 89 were selected for further analysis. A final total of 29 articles fulfilled the inclusion criteria; these included 10 retrospective case series, 11 prospective case series, 1 retrospective controlled clinical trial, 1 prospective controlled clinical trial, and 6 randomized controlled clinical trials. In general, evaluations of aesthetic results appear only in the more recent studies and refer mostly to implant rehabilitation in the maxillary anterior zone; the index used, in most cases, was the Papilla Index of Jemt. Conclusions: Although there appears to be a growing interest in aesthetics in dental implantology, there are as yet no universally accepted evaluation criteria of the aesthetic result. Therefore, further research is necessary to establish a common, complete, and reproducible index for the evaluation of aesthetic outcome that can add in the success criteria for implant therapy in the maxillary and mandibular anterior areas.     

From the Cover: AAA ATPase p97/VCP is essential for TRIM21-mediated virus neutralization

Tripartite motif-containing 21 (TRIM21) is a cytosolic IgG receptor that mediates intracellular virus neutralization by antibody. TRIM21 targets virions for destruction in the proteasome, but it is unclear how a substrate as large as a viral capsid is degraded. Here, we identify the ATPase p97/valosin-containing protein (VCP), an enzyme with segregase and unfoldase activity, as a key player in this process. Depletion or catalytic inhibition of VCP prevents capsid degradation and reduces neutralization. VCP is required concurrently with the proteasome, as addition of inhibitor after proteasomal degradation has no effect. Moreover, our results suggest that it is the challenging nature of virus as a substrate that necessitates involvement of VCP, since intracellularly expressed IgG Fc is degraded in a VCP-independent manner. These results implicate VCP as an important host factor in antiviral immunity.     

Elevated serum uric acid is associated with a greater inflammatory response and with short- and long-term mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Background and aimsDespite elevated serum uric acid (eSUA) has been identified as independent risk factor for cardiovascular diseases, its prognostic value in the setting of ST-segment elevation myocardial infarction (STEMI) is still controversial. Although the mechanisms of this possible relationship are unsettled it has been suggested that eSUA could trigger the inflammatory response. This study sought to investigate the association between eSUA with short- and long-term mortality and with inflammatory response in patients with STEMI treated with primary percutaneous coronary intervention (pPCI).Methods and resultsBlood samples were collected on admission and at 24 and 48 h after pPCI: the inflammatory biomarkers C-reactive protein (CRP), neutrophil count and neutrophil to lymphocytes ratio (NLR) were considered. Baseline eSUA was defined as ≥6.8 mg/dl. Cumulative 30-days and 1-year mortalities were estimated using the Kaplan-Meyer analysis. Multivariable analyses were performed by Cox proportional hazard models.In the 2369 patients with STEMI considered, 30-day mortality was 5.8% among patients with eSUA and 2% among patient with normal SUA level (p < 0.001); 1-year mortality was 8.5% vs 4%, respectively (p < 0.001). At multivariable analyses eSUA was an independent predictor of 30-day mortality (HR 1.196, 95%CI 1.006–1.321, p = 0.042) and 1-year mortality (HR 1.178, 95%CI 1.052–1.320, p = 0.005). eSUA patients presented higher values in on admission CRP (p < 0.001) and in neutrophil count and NLR at 24 h (respectively, p = 0.020 and p < 0.001) and at 48 h (p = 0.018 and p < 0.001) compared to patients with normal SUA levels.ConclusionsElevated serum uric acid is associated with higher short- and long-term mortality and with a greater inflammatory response after reperfusion in patients with STEMI treated with primary PCI.     

Dynamic Hypnosis,IBS, and the Value of Individualizing Treatment: A Clinical Perspective

Hypnosis has already been proven efficient in treatment of irritable bowel syndrome (IBS). The author was responsible for the hypnotherapy in a Swedish study and adds her clinical experience with IBS patients within and beyond that study. The hypnosis was labeled dynamic, and the treatment utilized the therapists’ clinical competence and individually tailored techniques, including gut-oriented symptom relief and hypnoanalysis, separately or in combination. The author presents 2 cases, 1 with a focus on symptom relief and 1 on exploring traumatic causes. She illustrates her clinical rationale for technical flexibility from trauma resolving hypnoanalysis to symptom-alleviating suggestive hypnosis, including dynamics beyond the symptom when such are part of the case history.     

Self-reported health-related quality of life of children and adolescent survivors of extracranial childhood malignancies: a Finnish nationwide survey

Purpose  

The purpose of this Finnish total cohort survey was to assess and compare the self-reported health-related quality of life (HRQL) in childhood cancer survivors to that of matched controls, to analyse demographic and disease-related factors explaining survivors’ HRQL, and to compare the results of two different HRQL instruments, 16D/17D and PedsQL™.     

IBS? Integrated Bigatti Shaver versus conventional bipolar resectoscopy: a randomised comparative study

Conventional bipolar resectoscopy is widely recognized as the first choice for major hysteroscopic operations. We recently proposed an alternative approach to operative hysteroscopy called Integrated Bigatti Shaver (IBS?) that improves visualization during the procedure, reducing several problems of conventional resectoscopy such as fluid overload, water intoxication, uterine perforation and long surgeon’s learning curve. In cooperation with Karl Storz GmbH & Co., we created a new shaving system that, when introduced through the straight operative channel of a panoramic 90° optic, allows performance of many major hysteroscopic operations. The present randomised comparative study was designed to compare 50 cases performed with conventional bipolar resectoscope with 50 cases performed with the IBS?. Several types of major intrauterine pathologies such as polyps and submucosal myomas (according to ESGE classification) were included in the study. Two cases of via falsa were reported. In one case, the procedure was immediately stopped with no further complication for the patient, whereas in the second patient, the complication did not compromise the operative course. Dilatation time, overall procedure time, resection time and fluid balance were carefully monitored during each procedure in the two groups. The aim of the study was to compare the two techniques to confirm several advantages offered by the IBS? such as reduced dilatation of the cervix, better visualization during the procedure because tissue chips are removed at the same time as the resection, no need for coagulation or cutting current, utilization of normal saline and a much faster learning curve.